UCSD Musculoskeletal Radiology
bonepit.com
Case of the week 004
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UCSD Musculoskeletal Radiology bonepit.com Case of the week 004 |
Dec 23th 2002 Submitted by Jose de Lima Prior cases of the week
History.
27 yo male s/p MVA
Pictures.
Questions.
Types of hip dislocations
How often are hip dislocations anterior?
Complications
Answers.
Posterior (most common), anterior, central and, rarely, luxatio erecta.
Anterior hip dislocations comprise 5-10% of hip dislocations.
Complications: fracture of the femoral head, neck, shaft, and/or acetabulum, labral tears, periarticular calcification and ossification, osteonecrosis of the femoral head (25% in posterior hip dislocations), secondary OA.
Discussion.
Hip dislocations require considerable trauma. They comprise 5% of all dislocations.
Anterior hip dislocations are caused by forced abduction and external rotation of the leg.
X-rays: Femoral head inferomedially displaced with abducted and externally rotated femur.
Depression or flattening of the postero superior and lateral portion of the femoral head (as seen in this case) is characteristic.
Pinpkin Classification: Describes fractures of the femoral head after dislocations of the hip.
Type I: Fracture of the femoral head inferior to the fovea.
Type II: Fracture of the femoral head at or superior to the fovea.
Type III: Fracture of the femoral head and neck.
Type IV: Fracture of the femoral head and acetabulum (as in this case).